Utility and Value of Flexible Epidemiologists

Surveys of State, Tribal, Local and Territorial (STLT) Governmental Health Agencies

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0879 can be found here:

Documents and Forms

Document Name Document Type
Utility and Value of Flexible Epidemiologists Form
Interview Guide - PI Attachment B Interview Guide - Version PI_ 12 2 13.docx Form
Interview Guide - Epidemiologist Attachment C Interview Guide - Version FE_12 2 13.docx Form
Flex Epi- Supporting_Statement_B_12 2 13.docx Supporting Statement B IC Document
Flex Epi- Supporting_Statement_A 12 2 13.docx Supporting Statement A IC Document
Attachment A ELC Logic Model_12 2 13.pdf A - Logic Model IC Document
Attachment D Invitation 12 2 13.docx D - Email Invitation IC Document
Attachment E Invitation Reminder_12 2 13.docx E - Email Reminder IC Document
Attachment F Confirmation Email_12 2 13.docx F - Email Confirmation IC Document

Information Collection (IC) Details

IC Title:	Utility and Value of Flexible Epidemiologists	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	none	Interview Guide - PI	Attachment B Interview Guide - Version PI_ 12 2 13.docx		No	No	Printable Only
Form	none	Interview Guide - Epidemiologist	Attachment C Interview Guide - Version FE_12 2 13.docx		No	No	Printable Only

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 20	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	20	0	0	0	0	0
Annual IC Time Burden (Hours)	13	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Supporting Statement B	Flex Epi- Supporting_Statement_B_12 2 13.docx	12/02/2013
Supporting Statement A	Flex Epi- Supporting_Statement_A 12 2 13.docx	12/02/2013
A - Logic Model	Attachment A ELC Logic Model_12 2 13.pdf	12/02/2013
D - Email Invitation	Attachment D Invitation 12 2 13.docx	12/02/2013
E - Email Reminder	Attachment E Invitation Reminder_12 2 13.docx	12/02/2013
F - Email Confirmation	Attachment F Confirmation Email_12 2 13.docx	12/02/2013

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.